Theresa A Wiese, LCSW is a medicare enrolled "Counselor - Mental Health" provider in Washington, Illinois. Her current practice location is
310 Hillcrest Dr, Washington, Illinois. You can reach out to her office (for appointments etc.) via phone at
(309) 645-1318.
Theresa A Wiese is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1891750816.
Healthcare Provider's Profile
Full Name | Theresa A Wiese |
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Gender | Female |
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Speciality | Counselor - Mental Health |
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Location | 310 Hillcrest Dr, Washington, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1891750816
- Provider Enumeration Date: 04/20/2006
- Last Update Date: 05/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 4789040080
- Enrollment ID: I20230511000778
Medical Identifiers
Medical identifiers for Theresa A Wiese such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1891750816 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Theresa A Wiese allows following entities to bill medicare on her behalf.
Entity Name | Osf Multi-specialty Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theresa A Wiese is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Theresa A Wiese, LCSW 310 Hillcrest Dr, Washington, IL 61571-2221 Ph: (309) 645-1318 | Theresa A Wiese, LCSW 310 Hillcrest Dr, Washington, IL 61571-2221 Ph: (309) 645-1318 |
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